Why Men in Safety-Critical Roles Don’t Speak Up About Mental Health and How This Leads to Medication Risks Managers Miss
- SanoMed Solutions Team
- Nov 22
- 4 min read
Men working in safety-critical environments (rail, construction, aviation, transport, utilities) carry a quiet burden. They are expected to be calm, focused, stable, and reliable at all times. The reality is more complex: many of these roles attract men who naturally internalise stress, hide symptoms, and avoid talking about their mental wellbeing until the point of crisis.
This silence doesn’t just affect their health; it directly affects safety. Unspoken stress, untreated mental health conditions, and undisclosed medication use can all impair judgement and increase the risk of incidents. For managers responsible for staff operating heavy machinery or making split-second decisions, understanding this dynamic is essential.
A meta-analysis of the associations between men's attitudes and self-stigma toward psychological help-seeking and masculinity ideology and gender role conflict across 35 samples, found that endorsement of traditional masculinity is strong associated with negative attitudes towards seeking psychological help. Higher masculinity ideology correlates with more self-stigma about help-seeking.
The Cultural Barrier: “I’ll cope on my own”
Many men feel an ingrained pressure to remain strong and self-sufficient. In safety-critical roles, this pressure is amplified by a workplace culture that values resilience, consistency, and reliability.
Common beliefs reported by male workers include:
“Talking about stress means I can’t handle the job.”
“If I say something, they might take me off duty.”
“Other people have it worse; mine isn’t important.”
“I don’t want to be seen as a problem.”
These beliefs keep employees silent even when they are struggling, and often long after their mental health begins affecting their performance.
The Fear of Being Declared ‘Unfit for Duty’
One of the biggest reasons men avoid speaking up is the fear of being removed from safety-critical tasks. For many, these triggers concern about:
Loss of pay
Loss of identity
Impact on their family
Stigma from colleagues
Worry about “being seen as unreliable”
Because of this, some will avoid Occupational Health entirely, hoping symptoms resolve on their own. Others will self-manage using medication without understanding how it affects safety-critical work.
Research using the HILDA cohort (Australia) looked at help-seeking in male-dominated vs non-male-dominated occupations. For men in male-dominated jobs, the odds of seeking professional mental health help were significantly lower (OR = 0.66).
How Silence Leads to Hidden Medication Risks
When men don’t talk about mental health symptoms, they often don’t talk about medication either.
Managers frequently encounter situations like:
Employees taking sedating antihistamines or painkillers without realising they impair alertness
Workers borrowing medication from relatives (e.g., sleeping tablets, anxiolytics)
Men starting antidepressants but hiding side effects through fear of being “taken off duties”
Increased caffeine or energy drink use masking fatigue
Over-the-counter medication taken with no awareness of safety implications
Herbal remedies such as St John’s Wort causing interactions
These risks usually remain invisible until something goes wrong; or until a manager notices changes in behaviour.
In roles where attention, coordination, memory and reaction time matter, even mild impairment can have serious consequences.
Signs Managers Commonly Miss in Men
Because men often mask how they’re feeling, the earliest signs appear subtly in behaviour:
Irritability or short temper
Withdrawal and silence
Reduced attention to detail
Slowed responses or poor concentration
Cutting corners
Increased sickness absence
Appearing “tired all the time”
Over-reliance on caffeine, nicotine or alcohol
These are easy to misinterpret as attitude issues, poor performance or “just stress”. In reality, they may be early signs of deteriorating mental health, or side effects of undisclosed medication.
Why Managers Need a Safe Space for Advice
Managers are often placed in impossible situations. They must balance compassion with safety and regulatory obligations. Yet most:
Are not trained to understand medication effects
Do not know which drugs cause impairment
Worry about overreacting or underreacting
Lack access to quick clinical guidance
This gap creates risk.
When a manager can access reliable Occupational Health medication advice in minutes (not days) it transforms the decision-making process. It means they can act early, support staff appropriately, and prevent unsafe situations before they unfold.
Creating a Culture Where Men Feel Safe to Speak Up
Men open up when the environment feels:
Confidential
Non-judgemental
Practical, not emotional
Clear about what will and won’t happen next
Managers can support this by:
Asking open, neutral questions
Focusing on function, not diagnosis
Reassuring staff that early disclosure often prevents removal from duty
Normalising mental health conversations
Encouraging staff to check medication before taking it
The goal isn’t to diagnose, it's to keep people safe!
When Silence Breaks, Safety Improves
When men feel able to discuss their mental health and medication honestly, everyone benefits:
Employees feel supported
Managers make informed decisions
Occupational Health receives issues early
Risk is reduced
Safety-critical operations run more smoothly
Silence leads to hidden risks. Conversation enables prevention.
A scoping review found that a higher psychosocial safety climate (i.e., when an organization prioritises communication, mental well-being, and psychological risk) directly improves health and safety outcomes. PSC moderates the impact of high job demands and helps improve performance.
Final Thoughts
Men in safety-critical roles often carry the weight of responsibility quietly. But unspoken stress, untreated symptoms, and undisclosed medication can put both the individual and the organisation at risk.
The solution isn’t to reduce standards, it’s to improve communication and give managers fast, reliable access to specialist advice.
By bridging this gap, employers can support men’s mental health while maintaining the highest standards of safety.
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